Diaphragmatic Injury in Patients with Penetrating Thoracoabdominal Injuries without Shock or Acute Abdomen at Admission. A cross sectional study

Se realizó un estudio transversal, unicéntrico, en Bogotá, Colombia. El estudio incluyó a todos los pacientes con IATP sometidos a exploración quirúrgica y que ingresaron sin signos de shock o abdomen agudo, entre enero de 2019 y agosto de 2021. Las indicaciones para la exploración quirúrgica incluy...

Full description

Autores:

Tipo de recurso:

Fecha de publicación:: 2024

Institución:: Universidad del Rosario

Repositorio:: Repositorio EdocUR - U. Rosario

Idioma:: spa

id	EDOCUR2_4ed334abbcfd37ea1581e209ca8ffb9f
oai_identifier_str	oai:repository.urosario.edu.co:10336/43263
network_acronym_str	EDOCUR2
network_name_str	Repositorio EdocUR - U. Rosario
repository_id_str
dc.title.none.fl_str_mv	Diaphragmatic Injury in Patients with Penetrating Thoracoabdominal Injuries without Shock or Acute Abdomen at Admission. A cross sectional study
dc.title.TranslatedTitle.none.fl_str_mv	Lesiones diafragmaticas en pacientes con heridas penetrantes toracoabdominales sin choque o abdomen agudo al ingreso. un estudio de corte transversal
title	Diaphragmatic Injury in Patients with Penetrating Thoracoabdominal Injuries without Shock or Acute Abdomen at Admission. A cross sectional study
spellingShingle	Diaphragmatic Injury in Patients with Penetrating Thoracoabdominal Injuries without Shock or Acute Abdomen at Admission. A cross sectional study Diafragma Exploración quirúrgica Dolor abdominal Hipotensión Anemia Diaphragmatic Traumatic IATP (Abdominal Thoraco-Pelvic Injury) Cross-sectional study Unicentric
title_short	Diaphragmatic Injury in Patients with Penetrating Thoracoabdominal Injuries without Shock or Acute Abdomen at Admission. A cross sectional study
title_full	Diaphragmatic Injury in Patients with Penetrating Thoracoabdominal Injuries without Shock or Acute Abdomen at Admission. A cross sectional study
title_fullStr	Diaphragmatic Injury in Patients with Penetrating Thoracoabdominal Injuries without Shock or Acute Abdomen at Admission. A cross sectional study
title_full_unstemmed	Diaphragmatic Injury in Patients with Penetrating Thoracoabdominal Injuries without Shock or Acute Abdomen at Admission. A cross sectional study
title_sort	Diaphragmatic Injury in Patients with Penetrating Thoracoabdominal Injuries without Shock or Acute Abdomen at Admission. A cross sectional study
dc.contributor.advisor.none.fl_str_mv	Rodriguez Lima, David Rene Rios Cadavid, Angela Cristina
dc.subject.none.fl_str_mv	Diafragma Exploración quirúrgica Dolor abdominal Hipotensión Anemia
topic	Diafragma Exploración quirúrgica Dolor abdominal Hipotensión Anemia Diaphragmatic Traumatic IATP (Abdominal Thoraco-Pelvic Injury) Cross-sectional study Unicentric
dc.subject.keyword.none.fl_str_mv	Diaphragmatic Traumatic IATP (Abdominal Thoraco-Pelvic Injury) Cross-sectional study Unicentric
description	Se realizó un estudio transversal, unicéntrico, en Bogotá, Colombia. El estudio incluyó a todos los pacientes con IATP sometidos a exploración quirúrgica y que ingresaron sin signos de shock o abdomen agudo, entre enero de 2019 y agosto de 2021. Las indicaciones para la exploración quirúrgica incluyeron: presencia de herida toracoabdominal izquierda, hemo o neumotórax en las imágenes prequirúrgicas, dolor abdominal, hipotensión o anemia.
publishDate	2024
dc.date.accessioned.none.fl_str_mv	2024-08-12T18:57:41Z
dc.date.available.none.fl_str_mv	2024-08-12T18:57:41Z
dc.date.created.none.fl_str_mv	2024-08-01
dc.type.none.fl_str_mv	bachelorThesis
dc.type.coar.fl_str_mv	http://purl.org/coar/resource_type/c_7a1f
dc.type.document.none.fl_str_mv	Trabajo de grado
dc.type.spa.none.fl_str_mv	Trabajo de grado
dc.identifier.uri.none.fl_str_mv	https://repository.urosario.edu.co/handle/10336/43263
url	https://repository.urosario.edu.co/handle/10336/43263
dc.language.iso.none.fl_str_mv	spa
language	spa
dc.rights.*.fl_str_mv	Attribution-NonCommercial-NoDerivatives 4.0 International
dc.rights.coar.fl_str_mv	http://purl.org/coar/access_right/c_abf2
dc.rights.acceso.none.fl_str_mv	Abierto (Texto Completo)
dc.rights.uri.*.fl_str_mv	http://creativecommons.org/licenses/by-nc-nd/4.0/
rights_invalid_str_mv	Attribution-NonCommercial-NoDerivatives 4.0 International Abierto (Texto Completo) http://creativecommons.org/licenses/by-nc-nd/4.0/ http://purl.org/coar/access_right/c_abf2
dc.format.extent.none.fl_str_mv	20 PP
dc.format.mimetype.none.fl_str_mv	application/pdf
dc.publisher.none.fl_str_mv	Universidad del Rosario
dc.publisher.department.none.fl_str_mv	Escuela de Medicina y Ciencias de la Salud
dc.publisher.program.none.fl_str_mv	Especialización en Cirugía General
publisher.none.fl_str_mv	Universidad del Rosario
institution	Universidad del Rosario
dc.source.bibliographicCitation.none.fl_str_mv	Mjoli M, Oosthuizen G, Clarke D, Madiba T. Laparoscopy in the diagnosis and repair of diaphragmatic injuries in left-sided penetrating thoracoabdominal trauma: Laparoscopy in trauma. Surg Endosc. marzo de 2015;29(3):747-52. D’Souza N, Bruce JL, Clarke DL, Laing GL. Laparoscopy for Occult Left-sided Diaphragm Injury Following Penetrating Thoracoabdominal Trauma is Both Diagnostic and Therapeutic. Surg Laparosc Endosc Percutan Tech. febrero de 2016;26(1):e5-8. Yucel M, Bas G, Kulalı F, Unal E, Ozpek A, Basak F, et al. Evaluation of diaphragm in penetrating left thoracoabdominal stab injuries: The role of multislice computed tomography. Injury. septiembre de 2015;46(9):1734-7. Turmak M, Deniz MA, Özmen CA, Aslan A. Evaluation of the multi-slice computed tomography outcomes in diaphragmatic injuries related to penetrating and blunt trauma. Clin Imaging. enero de 2018;47:65-73. Bautista-Parada IR, Bustos-Guerrero AM. Prevalencia de lesiones torácicas y abdominales en pacientes con traumatismo toracoabdominal penetrante. Cir Cir. 19 de mayo de 2022;90(3):6871. Prunty MC, Kudav S, Quick JA. Laparoscopic Management of Penetrating Thoracoabdominal Trauma. J Laparoendosc Adv Surg Tech. junio de 2018;28(6):736-9. Kesavaramanujam S, Morell MC, Harigovind D, Bhimmanapalli C, Cassaro S. Total thoracic herniation of the liver: a case of delayed right-sided diaphragmatic hernia after blunt trauma. Surg Case Rep. diciembre de 2020;6(1):178. Agrusa A, Romano G, Chianetta D, De Vita G, Frazzetta G, Di Buono G, et al. Right diaphragmatic injury and lacerated liver during a penetrating abdominal trauma: case report and brief literature review. World J Emerg Surg. diciembre de 2014;9(1):33. Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for reporting observational studies. Int J Surg. diciembre de 2014;12(12):1495-9. Koto ZM, Mosai F, Matsevych OY. The use of laparoscopy in managing penetrating thoracoabdominal injuries in Africa: 83 cases reviewed. World J Emerg Surg. diciembre de 2017;12(1):27. Koto MZ, Matsevych OY, Nsakala L. Evaluation of Thoracoscopy with Single-Lumen Endotracheal Tube Intubation and Laparoscopy in the Diagnosis of Occult Diaphragmatic Injuries in Penetrating Thoracoabdominal Trauma. J Laparoendosc Adv Surg Tech. junio de 2019;29(6):785-9. Barbois S, Abba J, Guigard S, Quesada JL, Pirvu A, Waroquet PA, et al. Management of penetrating abdominal and thoraco-abdominal wounds: A retrospective study of 186 patients. J Visc Surg. agosto de 2016;153(4):69-78. Ilhan M, Gök AK, Bademler S, Cücük Ö, Soytaş Y, Yanar H. Comparison of single incision and multi incision diagnostic laparoscopy on evaluation of diaphragmatic status after left thoracoabdominal penetrating stab wounds. J Minimal Access Surg. 2017;13(1):13. Alizade E, İlhan M, Durak G, Kaan Gok A, Ertekin C. Can invasive diagnostic methods be reduced by magnetic resonance imaging in the diagnosis of diaphragmatic injuries in left thoracoabdominal penetrating injuries? J Minimal Access Surg. 2022;18(3):431. Ahmed M, Mikael A, Gorski Y, Mahmoud A, Cordero R. Nonoperative Management of Penetrating Right Thoracoabdominal Injury. Cureus [Internet]. 22 de mayo de 2021 [citado 26 de enero de 2024]; Disponible en: https://www.cureus.com/articles/58567-nonoperative-management-of-penetrating-right-thoracoabdominal-injury Menegozzo CAM, Damous SHB, Alves PHF, Rocha MC, Collet E Silva FS, Baraviera T, et al. “Pop in a scope”: attempt to decrease the rate of unnecessary nontherapeutic laparotomies in hemodynamically stable patients with thoracoabdominal penetrating injuries. Surg Endosc. enero de 2020;34(1):261-7.
dc.source.instname.none.fl_str_mv	instname:Universidad del Rosario
dc.source.reponame.none.fl_str_mv	reponame:Repositorio Institucional EdocUR
bitstream.url.fl_str_mv	https://repository.urosario.edu.co/bitstreams/93c14cb6-cc9b-44a0-9f84-6fa049ebdb53/download https://repository.urosario.edu.co/bitstreams/5e988291-78b4-4c39-a1c5-1915e536b040/download https://repository.urosario.edu.co/bitstreams/fa482694-27b8-4d47-9a62-b8dd750ea1db/download https://repository.urosario.edu.co/bitstreams/65660b09-4444-4aef-945c-bff6a6e8662e/download https://repository.urosario.edu.co/bitstreams/38fc510e-195a-4424-832a-2759f9ec8b5c/download
bitstream.checksum.fl_str_mv	b2825df9f458e9d5d96ee8b7cd74fde6 3b6ce8e9e36c89875e8cf39962fe8920 2a264a564054716d399d6832bd617a40 c2c9ea663b57547dd7687f8ffe1c4ed7 08ffa577feaf366cebc7e98576f9699b
bitstream.checksumAlgorithm.fl_str_mv	MD5 MD5 MD5 MD5 MD5
repository.name.fl_str_mv	Repositorio institucional EdocUR
repository.mail.fl_str_mv	edocur@urosario.edu.co
_version_	1808390798881849344
spelling	Rodriguez Lima, David Reneddeda4bc-05f4-4383-a85b-6615d86b1790-1Rios Cadavid, Angela Cristinad1a8f39a-8591-4cf6-a488-098b16dd9d74-1Rodriguez Narvaez, Jose GabrielEspecialista en Cirugía GeneralMaestríaFull time9bb9aebe-b6e2-473b-8daa-b3b6c830e7e4-12024-08-12T18:57:41Z2024-08-12T18:57:41Z2024-08-01Se realizó un estudio transversal, unicéntrico, en Bogotá, Colombia. El estudio incluyó a todos los pacientes con IATP sometidos a exploración quirúrgica y que ingresaron sin signos de shock o abdomen agudo, entre enero de 2019 y agosto de 2021. Las indicaciones para la exploración quirúrgica incluyeron: presencia de herida toracoabdominal izquierda, hemo o neumotórax en las imágenes prequirúrgicas, dolor abdominal, hipotensión o anemia.Penetrating Thoracoabdominal Injuries (PTAI) are associated with diaphragmatic injuries and subsequent complications. This study aimed to describe the prevalence of diaphragmatic injuries in patients with PTAI without signs of shock or acute abdomen at admission. Materials and Methods A cross-sectional, single-centered study was conducted in Bogotá, Colombia. The study included all patients with PTAI who underwent surgical exploration and were admitted without signs of shock or acute abdomen, between January 2019 and August 2021. Indications for surgical exploration included: presence of left thoracoabdominal wound, hemo or pneumothorax in pre-surgical imaging, abdominal pain, hypotension or anemia. Results A total of 284 patients were included in the final analysis. The median age was 29 years [IQR 22-33], with 269 patients (94.7%) being males. Out of these, 268 (94.3%) patients experienced stabbing as the mechanism of injury. The prevalence of diaphragmatic injuries diagnosed during surgical exploration was 15.1% (43 patients). There were 183 patients with left-side PTAI and 115 patients with right-side PTAI. The prevalence of right diaphragmatic injury was 25.2% (29 patients), while for left diaphragmatic injury it was 8.1% (15 patients). Only 1 patient presented with bilateral diaphragmatic injury. Conclusions The prevalence of diaphragmatic injuries in patients with PTAI, without signs of shock or acute abdomen upon admission, was 15.1%. However, the prevalence was 25.2% in right PTAI and 8.1% in left PTAI. These findings suggest that surgical exploration of the diaphragm in cases of PTAI should be performed regardless of the side of the wound.20 PPapplication/pdfBogotáhttps://repository.urosario.edu.co/handle/10336/43263spaUniversidad del RosarioEscuela de Medicina y Ciencias de la SaludEspecialización en Cirugía GeneralAttribution-NonCommercial-NoDerivatives 4.0 InternationalAbierto (Texto Completo)EL AUTOR, manifiesta que la obra objeto de la presente autorización es original y la realizó sin violar o usurpar derechos de autor de terceros, por lo tanto la obra es de exclusiva autoría y tiene la titularidad sobre la misma. PARGRAFO: En caso de presentarse cualquier reclamación o acción por parte de un tercero en cuanto a los derechos de autor sobre la obra en cuestión, EL AUTOR, asumirá toda la responsabilidad, y saldrá en defensa de los derechos aquí autorizados; para todos los efectos la universidad actúa como un tercero de buena fe. EL AUTOR, autoriza a LA UNIVERSIDAD DEL ROSARIO, para que en los términos establecidos en la Ley 23 de 1982, Ley 44 de 1993, Decisión andina 351 de 1993, Decreto 460 de 1995 y demás normas generales sobre la materia, utilice y use la obra objeto de la presente autorización. -------------------------------------- POLITICA DE TRATAMIENTO DE DATOS PERSONALES. Declaro que autorizo previa y de forma informada el tratamiento de mis datos personales por parte de LA UNIVERSIDAD DEL ROSARIO para fines académicos y en aplicación de convenios con terceros o servicios conexos con actividades propias de la academia, con estricto cumplimiento de los principios de ley. Para el correcto ejercicio de mi derecho de habeas data cuento con la cuenta de correo habeasdata@urosario.edu.co, donde previa identificación podré solicitar la consulta, corrección y supresión de mis datos.http://creativecommons.org/licenses/by-nc-nd/4.0/http://purl.org/coar/access_right/c_abf2Mjoli M, Oosthuizen G, Clarke D, Madiba T. Laparoscopy in the diagnosis and repair of diaphragmatic injuries in left-sided penetrating thoracoabdominal trauma: Laparoscopy in trauma. Surg Endosc. marzo de 2015;29(3):747-52.D’Souza N, Bruce JL, Clarke DL, Laing GL. Laparoscopy for Occult Left-sided Diaphragm Injury Following Penetrating Thoracoabdominal Trauma is Both Diagnostic and Therapeutic. Surg Laparosc Endosc Percutan Tech. febrero de 2016;26(1):e5-8.Yucel M, Bas G, Kulalı F, Unal E, Ozpek A, Basak F, et al. Evaluation of diaphragm in penetrating left thoracoabdominal stab injuries: The role of multislice computed tomography. Injury. septiembre de 2015;46(9):1734-7.Turmak M, Deniz MA, Özmen CA, Aslan A. Evaluation of the multi-slice computed tomography outcomes in diaphragmatic injuries related to penetrating and blunt trauma. Clin Imaging. enero de 2018;47:65-73.Bautista-Parada IR, Bustos-Guerrero AM. Prevalencia de lesiones torácicas y abdominales en pacientes con traumatismo toracoabdominal penetrante. Cir Cir. 19 de mayo de 2022;90(3):6871.Prunty MC, Kudav S, Quick JA. Laparoscopic Management of Penetrating Thoracoabdominal Trauma. J Laparoendosc Adv Surg Tech. junio de 2018;28(6):736-9.Kesavaramanujam S, Morell MC, Harigovind D, Bhimmanapalli C, Cassaro S. Total thoracic herniation of the liver: a case of delayed right-sided diaphragmatic hernia after blunt trauma. Surg Case Rep. diciembre de 2020;6(1):178.Agrusa A, Romano G, Chianetta D, De Vita G, Frazzetta G, Di Buono G, et al. Right diaphragmatic injury and lacerated liver during a penetrating abdominal trauma: case report and brief literature review. World J Emerg Surg. diciembre de 2014;9(1):33.Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for reporting observational studies. Int J Surg. diciembre de 2014;12(12):1495-9.Koto ZM, Mosai F, Matsevych OY. The use of laparoscopy in managing penetrating thoracoabdominal injuries in Africa: 83 cases reviewed. World J Emerg Surg. diciembre de 2017;12(1):27.Koto MZ, Matsevych OY, Nsakala L. Evaluation of Thoracoscopy with Single-Lumen Endotracheal Tube Intubation and Laparoscopy in the Diagnosis of Occult Diaphragmatic Injuries in Penetrating Thoracoabdominal Trauma. J Laparoendosc Adv Surg Tech. junio de 2019;29(6):785-9.Barbois S, Abba J, Guigard S, Quesada JL, Pirvu A, Waroquet PA, et al. Management of penetrating abdominal and thoraco-abdominal wounds: A retrospective study of 186 patients. J Visc Surg. agosto de 2016;153(4):69-78.Ilhan M, Gök AK, Bademler S, Cücük Ö, Soytaş Y, Yanar H. Comparison of single incision and multi incision diagnostic laparoscopy on evaluation of diaphragmatic status after left thoracoabdominal penetrating stab wounds. J Minimal Access Surg. 2017;13(1):13.Alizade E, İlhan M, Durak G, Kaan Gok A, Ertekin C. Can invasive diagnostic methods be reduced by magnetic resonance imaging in the diagnosis of diaphragmatic injuries in left thoracoabdominal penetrating injuries? J Minimal Access Surg. 2022;18(3):431.Ahmed M, Mikael A, Gorski Y, Mahmoud A, Cordero R. Nonoperative Management of Penetrating Right Thoracoabdominal Injury. Cureus [Internet]. 22 de mayo de 2021 [citado 26 de enero de 2024]; Disponible en: https://www.cureus.com/articles/58567-nonoperative-management-of-penetrating-right-thoracoabdominal-injuryMenegozzo CAM, Damous SHB, Alves PHF, Rocha MC, Collet E Silva FS, Baraviera T, et al. “Pop in a scope”: attempt to decrease the rate of unnecessary nontherapeutic laparotomies in hemodynamically stable patients with thoracoabdominal penetrating injuries. Surg Endosc. enero de 2020;34(1):261-7.instname:Universidad del Rosarioreponame:Repositorio Institucional EdocURDiafragmaExploración quirúrgicaDolor abdominalHipotensiónAnemiaDiaphragmaticTraumaticIATP (Abdominal Thoraco-Pelvic Injury)Cross-sectional study UnicentricDiaphragmatic Injury in Patients with Penetrating Thoracoabdominal Injuries without Shock or Acute Abdomen at Admission. A cross sectional studyLesiones diafragmaticas en pacientes con heridas penetrantes toracoabdominales sin choque o abdomen agudo al ingreso. un estudio de corte transversalbachelorThesisTrabajo de gradoTrabajo de gradohttp://purl.org/coar/resource_type/c_7a1fEscuela de Medicina y Ciencias de la SaludBogotáLICENSElicense.txtlicense.txttext/plain1483https://repository.urosario.edu.co/bitstreams/93c14cb6-cc9b-44a0-9f84-6fa049ebdb53/downloadb2825df9f458e9d5d96ee8b7cd74fde6MD52CC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; charset=utf-8899https://repository.urosario.edu.co/bitstreams/5e988291-78b4-4c39-a1c5-1915e536b040/download3b6ce8e9e36c89875e8cf39962fe8920MD53ORIGINALDiaphragmatic_Injury_Patients_Rodriguez_Lima_Jose_Gabriel.pdfDiaphragmatic_Injury_Patients_Rodriguez_Lima_Jose_Gabriel.pdfapplication/pdf759696https://repository.urosario.edu.co/bitstreams/fa482694-27b8-4d47-9a62-b8dd750ea1db/download2a264a564054716d399d6832bd617a40MD54TEXTDiaphragmatic_Injury_Patients_Rodriguez_Lima_Jose_Gabriel.pdf.txtDiaphragmatic_Injury_Patients_Rodriguez_Lima_Jose_Gabriel.pdf.txtExtracted texttext/plain30982https://repository.urosario.edu.co/bitstreams/65660b09-4444-4aef-945c-bff6a6e8662e/downloadc2c9ea663b57547dd7687f8ffe1c4ed7MD55THUMBNAILDiaphragmatic_Injury_Patients_Rodriguez_Lima_Jose_Gabriel.pdf.jpgDiaphragmatic_Injury_Patients_Rodriguez_Lima_Jose_Gabriel.pdf.jpgGenerated Thumbnailimage/jpeg2882https://repository.urosario.edu.co/bitstreams/38fc510e-195a-4424-832a-2759f9ec8b5c/download08ffa577feaf366cebc7e98576f9699bMD5610336/43263oai:repository.urosario.edu.co:10336/432632024-08-13 03:01:32.376http://creativecommons.org/licenses/by-nc-nd/4.0/Attribution-NonCommercial-NoDerivatives 4.0 Internationalhttps://repository.urosario.edu.coRepositorio institucional EdocURedocur@urosario.edu.coRUwoTE9TKSBBVVRPUihFUyksIG1hbmlmaWVzdGEobWFuaWZlc3RhbW9zKSBxdWUgbGEgb2JyYSBvYmpldG8gZGUgbGEgcHJlc2VudGUgYXV0b3JpemFjacOzbiBlcyBvcmlnaW5hbCB5IGxhIHJlYWxpesOzIHNpbiB2aW9sYXIgbyB1c3VycGFyIGRlcmVjaG9zIGRlIGF1dG9yIGRlIHRlcmNlcm9zLCBwb3IgbG8gdGFudG8gbGEgb2JyYSBlcyBkZSBleGNsdXNpdmEgYXV0b3LDrWEgeSB0aWVuZSBsYSB0aXR1bGFyaWRhZCBzb2JyZSBsYSBtaXNtYS4KPGJyLz4KUEFSQUdSQUZPOiBFbiBjYXNvIGRlIHByZXNlbnRhcnNlIGN1YWxxdWllciByZWNsYW1hY2nDs24gbyBhY2Npw7NuIHBvciBwYXJ0ZSBkZSB1biB0ZXJjZXJvIGVuIGN1YW50byBhIGxvcyBkZXJlY2hvcyBkZSBhdXRvciBzb2JyZSBsYSBvYnJhIGVuIGN1ZXN0acOzbiwgRUwgQVVUT1IsIGFzdW1pcsOhIHRvZGEgbGEgcmVzcG9uc2FiaWxpZGFkLCB5IHNhbGRyw6EgZW4gZGVmZW5zYSBkZSBsb3MgZGVyZWNob3MgYXF1w60gYXV0b3JpemFkb3M7IHBhcmEgdG9kb3MgbG9zIGVmZWN0b3MgbGEgdW5pdmVyc2lkYWQgYWN0w7phIGNvbW8gdW4gdGVyY2VybyBkZSBidWVuYSBmZS4KPGhyLz4KRUwgQVVUT1IsIGF1dG9yaXphIGEgTEEgVU5JVkVSU0lEQUQgREVMIFJPU0FSSU8sICBwYXJhIHF1ZSBlbiBsb3MgdMOpcm1pbm9zIGVzdGFibGVjaWRvcyBlbiBsYSBMZXkgMjMgZGUgMTk4MiwgTGV5IDQ0IGRlIDE5OTMsIERlY2lzacOzbiBhbmRpbmEgMzUxIGRlIDE5OTMsIERlY3JldG8gNDYwIGRlIDE5OTUgeSBkZW3DoXMgbm9ybWFzIGdlbmVyYWxlcyBzb2JyZSBsYSBtYXRlcmlhLCAgdXRpbGljZSB5IHVzZSBsYSBvYnJhIG9iamV0byBkZSBsYSBwcmVzZW50ZSBhdXRvcml6YWNpw7NuLgoKLS0tLS0tLS0tLS0tLS0tLS0tLS0tLS0tLS0tLS0tLS0tLS0tLS0KClBPTElUSUNBIERFIFRSQVRBTUlFTlRPIERFIERBVE9TIFBFUlNPTkFMRVMuIERlY2xhcm8gcXVlIGF1dG9yaXpvIHByZXZpYSB5IGRlIGZvcm1hIGluZm9ybWFkYSBlbCB0cmF0YW1pZW50byBkZSBtaXMgZGF0b3MgcGVyc29uYWxlcyBwb3IgcGFydGUgZGUgTEEgVU5JVkVSU0lEQUQgREVMIFJPU0FSSU8gIHBhcmEgZmluZXMgYWNhZMOpbWljb3MgeSBlbiBhcGxpY2FjacOzbiBkZSBjb252ZW5pb3MgY29uIHRlcmNlcm9zIG8gc2VydmljaW9zIGNvbmV4b3MgY29uIGFjdGl2aWRhZGVzIHByb3BpYXMgZGUgbGEgYWNhZGVtaWEsIGNvbiBlc3RyaWN0byBjdW1wbGltaWVudG8gZGUgbG9zIHByaW5jaXBpb3MgZGUgbGV5LiBQYXJhIGVsIGNvcnJlY3RvIGVqZXJjaWNpbyBkZSBtaSBkZXJlY2hvIGRlIGhhYmVhcyBkYXRhICBjdWVudG8gY29uIGxhIGN1ZW50YSBkZSBjb3JyZW8gaGFiZWFzZGF0YUB1cm9zYXJpby5lZHUuY28sIGRvbmRlIHByZXZpYSBpZGVudGlmaWNhY2nDs24gIHBvZHLDqSBzb2xpY2l0YXIgbGEgY29uc3VsdGEsIGNvcnJlY2Npw7NuIHkgc3VwcmVzacOzbiBkZSBtaXMgZGF0b3MuCg==

Diaphragmatic Injury in Patients with Penetrating Thoracoabdominal Injuries without Shock or Acute Abdomen at Admission. A cross sectional study

Publicaciones similares